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OPINION

Tomah VA wrongdoing betrays veterans

Jason Simcakoski of Stevens Point was a veteran of the U.S. Marines, honorably discharged in 2002 as a corporal. He was a husband and a father of a baby daughter. He went by "Jake." He died in August of an overdose of prescription medications while in the care of the Tomah Veterans Affairs clinic's psychiatric ward. He had been prescribed more than a dozen medications.

Simcakoski's death was a tragedy. It may also have been a crime.

Following a report published by The Center for Investigative Reporting and Stevens Point Journal Media, the VA has launched an investigation into the practices of the Tomah clinic's chief of staff, psychiatrist David Houlihan, who appears to have severely overprescribed narcotic drugs to the veterans who came to Tomah for care — and not only that, but also to have reacted angrily, defensively and perhaps to have acted in retaliation toward those who questioned his practices.

The veterans who relied on Tomah for care called Houlihan "Candy Man," the CIR report revealed. Hospital staff called his combinations of opiates and other drugs "Houlihan cocktails." And vets called the clinic itself "Candy Land."

The evidence backs up the reputation. In less than a decade, prescriptions of oxycodone pills at the facility grew by a factor of 14, from 50,000 in 2004 to 712,000 by 2012. In March 2014, the VA's inspector general found that Houlihan's prescriptions "raised potentially serious concerns" and were well above the levels of opiates prescribed by most doctors.

This sort of cavalier attitude toward these drugs is a betrayal of the trust of Houlihan's patients, and one which very likely contributed to Simcakoski's death.

A text message from Marine Corps veteran Jason “Jake” Simcakoski to his father, before Simcakoski died Aug. 30, says that he felt “worse now” than before he started treatment at the Tomah VA facility.(Photo: Darren Hauck/Center for Investigative Reporting)

And because Houlihan treated veterans, because he worked at a VA clinic, it is also a betrayal of the public's trust. Our vets deserve better, and so do we.

VA Secretary Robert McDonald has reassigned Houlihan, barring him from the facility or from writing prescriptions. An investigation has been launched.

That's a good start, but it's not enough. Based on CIR's reporting, the evidence in this case appears to be pretty overwhelming. But the investigation that has already been launched will take time to complete if it is to be as thorough as necessary. For now, Houlihan has been reassigned to another job in the VA department. He should be suspended without pay while the investigation proceeds.

And let's be very clear about this: If the evidence warrants it, criminal charges against Houlihan should be considered a possible outcome of this investigation.

A flurry of statements from politicians followed the publication of this report. We have never seen so many statements of "deep concern" and "cause for alarm" and calls for "serious oversight" from politicians such as Rep. Ron Kind, D-La Crosse, who represents Tomah; U.S. Sens. Ron Ron Johnson and Tammy Baldwin; state Rep. Nancy Vander Meer, the newly elected GOP representative of Tomah in Madison; and more recently, U.S. Rep. Sean Duffy of Wausau.

They are right, of course. And in the best case, these statements will help create the political pressure necessary to spur better oversight in the future. But it's also worth noting that the CIR's report was not the first time public officials had heard about problems with this particular facility and this particular psychiatrist. There have been many reports, complaints and allegations, and even a few actions by elected officials.

Along with the investigation into Houlihan's potential wrongdoing, then, let's have answers to these questions: Why wasn't any of that enough to spur an actual change? Why did the problem fester?

Last year, the VA was embroiled in scandals following revelations of long wait times and horrible failures of administration at some urban locations. The problem uncovered here is a different one, but it shares a common theme: The VA establishment failed to provide the care our veterans needed, whether through incompetence or maliciousness, and the system of oversight that existed failed to find and correct problems.

We owe it to veterans like Simcakoski to investigate the problem, punish wrongdoing and fix the underlying issues so that this never happens again.

"I'm so anxious I'm going nutz (sic.) mentally with all this built up inside me," Simcakoski wrote in a text message to his father shortly before he died. "I slept horrible last night. I toss and turned sweating all night. I woke up over a dozen times. Then at 4 I just stayed up, I couldn't take it.